etoposide


Also found in: Dictionary, Acronyms, Wikipedia.
Related to etoposide: cisplatin, Ifosfamide

etoposide

 [e-to-po´sīd]
a semisynthetic derivative of podophyllotoxin used as the base or the phosphate salt as an antineoplastic agent in treatment of carcinoma of the testes, lung, or bladder, lymphoma, acute myelocytic leukemia, Ewing's sarcoma, and Kaposi's sarcoma; administered orally or intravenously.

etoposide (VP-16-213)

Eposin (UK), Toposar, VePesid

etoposide phosphate

Etopophos

Pharmacologic class: Podophyllotoxin derivative

Therapeutic class: Antineoplastic

Pregnancy risk category D

Action

Damages DNA before mitosis by inhibiting topoisomerase II enzyme. This action impairs DNA synthesis and inhibits selected cancer cell growth. Cell-cycle-phase specific.

Availability

Capsules: 50 mg

Injection: 20 mg/ml

Powder for injection (phosphate): 100 mg in single-dose vials

Indications and dosages

Testicular cancer

Adults: 50 to 100 mg/m2 I.V. daily for 5 days. Or 100 mg/m2 I.V. on days 1,3, and 5, with course repeated q 3 to 4 weeks.

Small-cell carcinoma of lung

Adults: 70 mg/m2 (rounded up or down to nearest 50 mg) P.O. daily for 4 days, then a maximum of 100 mg/m2 (rounded up or down to nearest 50 mg) P.O. daily for 5 days every 3 to 4 weeks. Alternatively, 35 mg/m2 I.V. daily for 4 days, then a maximum of 50 mg/m2 I.V. daily for 5 days q 3 to 4 weeks.

Dosage adjustment

• Renal impairment

Off-label uses

• AIDS-related Kaposi's sarcoma

• Wilms' tumor

• Neuroblastoma

• Malignant lymphoma

• Hodgkin's disease

• Ovarian neoplasms

Contraindications

• Hypersensitivity to drug or its components

Precautions

Use cautiously in:

• active infections, decreased bone marrow reserve, renal or hepatic impairment

• pregnant patients and patients with childbearing potential

• breastfeeding patients

• children (safety and efficacy not established).

Administration

• For I.V. concentrations above 0.4 mg/ml, mix each 100 mg with 250 to 500 ml of dextrose 5% in water or normal saline solution, to help prevent crystallization.

• Give I.V. infusion over 30 to 60 minutes. Don't use in-line filter.

Avoid rapid infusion, which may cause severe hypotension and bronchospasm.

• Administer with antiemetics, as prescribed.

• Wear disposable gloves when handling. If drug comes into contact with skin, wash thoroughly with soap and water.

• Be aware that drug is given with other chemotherapeutic agents.

Adverse reactions

CNS: drowsiness, fatigue, headache, vertigo, peripheral neuropathy

CV: hypotension (with I.V. use), heart failure, myocardial infarction

GI: nausea, vomiting, stomatitis

GU: sterility

Hematologic: anemia, leukopenia, thrombocytopenia, bone marrow depression

Hepatic: hepatotoxicity

Metabolic: hyperuricemia

Musculoskeletal: muscle cramps

Respiratory: pulmonary edema, bronchospasm

Other: alopecia, fever, phlebitis at I.V. site, allergic reactions including anaphylaxis

Interactions

Drug-drug. Live-virus vaccines: increased risk of adverse reactions

Other antineoplastics: additive bone marrow depression

Drug-diagnostic tests. Hemoglobin, neutrophils, platelets, red blood cells, white blood cells: decreased values

Uric acid: increased level

Patient monitoring

Monitor blood pressure during and after infusion. Stop infusion if severe hypotension occurs.

• With I.V. use, monitor infusion rate closely to prevent infusion reactions.

• Throughout infusion, check I.V. site for extravasation, which may cause thrombophlebitis.

Keep diphenhydramine, hydrocortisone, epinephrine, and artificial airway at hand in case anaphylaxis occurs.

• Assess for CNS adverse effects. Assist patient during ambulation as needed.

Monitor for signs and symptoms of bone marrow depression.

• Monitor CBC, liver function tests, and blood urea nitrogen and creatinine levels. Report platelet count below 50,000/mm3 or neutrophil count below 500/mm3.

Patient teaching

• Instruct patient to inspect mouth daily for ulcers and bleeding gums.

Tell patient to immediately report difficulty breathing or signs and symptoms of allergic reaction.

Caution female of childbearing age to avoid pregnancy and breastfeeding during drug therapy.

• Instruct patient to move slowly when sitting up or standing, to avoid lightheadedness or dizziness from sudden blood pressure decrease.

• Tell patient drug may cause hair loss.

• As appropriate, review all other significant and life-threatening adverse reactions and interactions, especially those related to the drugs and tests mentioned above.

etoposide

/eto·po·side/ (e″to-po´sīd) a semisynthetic derivative of podophyllotoxin used as the base or the phosphate salt as an antineoplastic, particularly for treating testicular tumors and small cell lung carcinoma.

etoposide

(ē′tə-pō′sīd′)
n.
A semisynthetic derivative of podophyllotoxin that is a mitotic inhibitor used in the treatment of refractory testicular tumors and small cell lung cancer.

etoposide

an antineoplastic or chemotherapeutic agent and mitotic inhibitor.
indications It is prescribed in the treatment of several forms of cancer, including lymphomas, cancer of the testicles and prostate, and small-cell lung cancer, to prevent tumor cells from dividing and spreading.
contraindications It should not be used if there is an allergy to etoposide or podophyllum. There is a potential adverse effect to the fetus if used by a pregnant patient, and the drug should not be used if breastfeeding.
adverse effects The side effects most often reported include chills, rapid heartbeat, painful or difficult breathing, decreased blood pressure, hair loss, rash, itching, skin discoloration, and digestive disorders.

etoposide

Oncology A chemotherapeutic active against monocytic leukemia, CNS lymphoma, refractory small cell carcinoma, testicular CA, and KS, which may be co-administered with cyclophosphamide and doxorubicin Adverse effects BM toxicity, hair loss, nausea, incoordination, stomatitis, dyspnea, anorexia. See AIDS, ALL.

etoposide

An anticancer drug derived from a plant poison epipodophyllotoxin. It is used chiefly in the maintenance treatment of acute leukaemia after remission has been achieved and the bone marrow has recovered. It has been given by mouth to treat lung cancer. The drug is on the WHO official list. A brand name is Vepeside.

etoposide

a derivative of podophyllotoxin with antineoplastic activity; used in the treatment of leukemias.
References in periodicals archive ?
Responses to high-dose TI-CE chemotherapy regimen in patients with relapsed germ cell tumours (n=79 patients) Response n % Combined % CR (chemotherapy 13 17% alone) 45% CR 70% CR (chemotherapy + 22 28% Favourable surgery) response Partial response 20 25% with negative markers CR: complete response; TI-CE: paclitaxel [T] plus ifosfamide [I] followed by high-dose carboplatin [C] plus etoposide [E].
A) (Top row) Electron micrographs of wild-type MEFs and Atg5-deficient MEFs treated with etoposide (10 [micro]M) for 18 h.
Entecavir and etoposide were eluted through column C18 ODS Hypersil column of 150 mm x 4.
Treatment of disseminated germ-cell tumors with cisplatin, bleomycin, and either vinblastine or etoposide.
Treatment ofpoorly differenciated neuroendocrine tumors with etoposide and cisplatin.
5), (9) Various regimens adding cisplatin as the main agent have been used, including etoposide, cyclophosphamide, doxorubicin and vincristine; carboplatin and etoposide; carboplatin and taxanes; and cisplatin, ifosfamide, and etoposide.
to oral Etoposide in patients free from disease after their second metastatic relapse.
The researchers compared various chemotherapy regimens and IFRT doses and found that outcomes were similar when 30 Gy of IFRT was combined with either four cycles of ABVD (doxorubicine, bleomycin, vinblastine, and dacarbazine) or four cycles of BEACOPP (bleomycin, etoposide, doxorubicin, cyclophosphamide, vincristine, procarbazine, prednisone).
Other tests showed juices can affect the absorption of anti-cancer drugs such as etoposide (Etopophos, Vepesid), beta blockers such as tenormin (Atenolol) and talinolol (Cordanum), and antibiotics such as ciprofloxacin (Cipro), levofloxacin (Levaquin) and itraconazole (Sporanox).
Name of trial A Phase Ib/II Study of CYT997 in Combination with Carboplatin and Etoposide in Relapsed Glioblastoma Multiforme (CCL08001).
To date, grapefruit, orange and apple juices have been shown to lower the absorption of etoposide (an anti-cancer agent), several beta-blockers (used to treat high blood pressure and prevent heart attacks), cyclosporine (which prevents rejection of transplanted organs) and certain antibiotics.
Drugs whose effectiveness was lowered included anti-cancer agent etoposide, beta blockers and cyclosporine, which prevents rejection of transplanted organs.